Abstract
High levels of stress during pregnancy can have lasting effects on maternal and offspring health, which disproportionately impacts families facing financial strain, systemic racism, and other forms of social oppression. Developing ways to monitor daily life stress during pregnancy is important for reducing stress-related health disparities. We evaluated the feasibility and acceptability of using mobile health (mHealth) technology (i.e., wearable biosensors, smartphone-based ecological momentary assessment) to measure prenatal stress in daily life. Fifty pregnant women (67% receiving public assistance; 70% Black, 6% Multiracial, 24% White) completed 10 days of ambulatory assessment, in which they answered smartphone-based surveys six times a day and wore a chest-band device (movisens EcgMove4) to monitor their heart rate, heart rate variability, and activity level. Feasibility and acceptability were evaluated using behavioral meta-data and participant feedback. Findings supported the feasibility and acceptability of mHealth methods: Participants answered approximately 75% of the surveys per day and wore the device for approximately 10 hours per day. Perceived burden was low. Notably, participants with higher reported stressors and financial strain reported lower burden associated with the protocol than participants with fewer life stressors, highlighting the feasibility of mHealth technology for monitoring prenatal stress among pregnant populations living with higher levels of contextual stressors. Findings support the use of mHealth technology to measure prenatal stress in real-world, daily life settings, which shows promise for informing scalable, technology-assisted interventions that may help to reduce health disparities by enabling more accessible and comprehensive care during pregnancy.
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Acknowledgements
Special thanks to the participants of the Pittsburgh Girls Study for their participation in this research and to our dedicated research team for their continued efforts.
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This research was supported by the National Institute of Mental Health (K01MH123505) and the National Institute of Health Environmental influences on Child Health Outcomes (ECHO) Program (UH3OD023244).
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All authors contributed to the study conception and design. Material preparation, data collection, and analyses were performed by I.T. and U.B. The first draft of the manuscript was written by I.T.; all authors provided feedback on previous versions of the manuscript. All authors approved the final manuscript.
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Tung, I., Balaji, U., Hipwell, A.E. et al. Feasibility and acceptability of measuring prenatal stress in daily life using smartphone-based ecological momentary assessment and wearable physiological monitors. J Behav Med (2024). https://doi.org/10.1007/s10865-024-00484-4
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DOI: https://doi.org/10.1007/s10865-024-00484-4